Student Information Form : Caribbean School of Data (CSOD)

Please complete the form below so that we may better serve you.

First name*

Last name*

Email*

What group have you been assigned to?*

When is your birthday?

How old are you?*

What is your sex?
MaleFemalePrefer not to say

Contact number*

What country are you applying from?*

Mailing address

What is your nationality?*

Select the item below that best describes your level of education
PrimarySecondaryTertiary/VocationalUndergraduateGraduatePost-Graduate

Select the item below that best describes your marital status
SingleMarriedCommon-LawDivorcedWidowed

Are you the head of your household?
NoYes

Do you have any children?
NoYes

How many children do you have?*

How would you describe the financial status of your family?
Below the poverty lineOn the poverty lineJust above the poverty lineComfortably above the poverty lineWell above the poverty line

What is your current primary source of income?*

How long has this been your primary source of income?*

How long do you expect this will continue to be your primary source of income?*

Do you depend on someone for financial support?
NoYes

Does anyone depend on you for financial support?
NoYes

Do you have any kind of disability?
NoYes

What disability do you have?*

Tell us a little about yourself*

Please explain your interest in ICT and Digital Skills*

Do you have any special skills you would like to tell us about?
NoYesPrefer not to say

Tell us about your special skills*

How did you hear about the Caribbean School of Data?
In the mediaFrom a friendFrom someone who knew about the program

Please indicate all of the following devices that you OWN:*
Mobile phone ('banger')SmartphoneTabletLaptopDesktop

Do you have access to the Internet from your home?
NoYesPrefer not to say

Do you have mobile access to the Internet?
NoYesPrefer not to say

Do you have access to the Internet from your workplace?
NoYesPrefer not to say